<?php
/* @var $this PersonalInformationController */
/* @var $model PersonalInformation */
/* @var $form CActiveForm */
?>

<div class="wide form">

<?php $form=$this->beginWidget('CActiveForm', array(
	'action'=>Yii::app()->createUrl($this->route),
	'method'=>'get',
)); ?>

	<div class="row">
		<?php echo $form->label($model,'id'); ?>
		<?php echo $form->textField($model,'id'); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'date_time'); ?>
		<?php echo $form->textField($model,'date_time'); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'fname'); ?>
		<?php echo $form->textField($model,'fname',array('size'=>45,'maxlength'=>45)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'lname'); ?>
		<?php echo $form->textField($model,'lname',array('size'=>45,'maxlength'=>45)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'mi'); ?>
		<?php echo $form->textField($model,'mi',array('size'=>2,'maxlength'=>2)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'b_date'); ?>
		<?php echo $form->textField($model,'b_date'); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'age'); ?>
		<?php echo $form->textField($model,'age'); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'gender'); ?>
		<?php echo $form->textField($model,'gender',array('size'=>8,'maxlength'=>8)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'email'); ?>
		<?php echo $form->textField($model,'email',array('size'=>45,'maxlength'=>45)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'address_no'); ?>
		<?php echo $form->textField($model,'address_no'); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'add_street'); ?>
		<?php echo $form->textField($model,'add_street',array('size'=>45,'maxlength'=>45)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'add_city'); ?>
		<?php echo $form->textField($model,'add_city',array('size'=>30,'maxlength'=>30)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'country'); ?>
		<?php echo $form->textField($model,'country',array('size'=>30,'maxlength'=>30)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'zip'); ?>
		<?php echo $form->textField($model,'zip'); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'home_tel'); ?>
		<?php echo $form->textField($model,'home_tel'); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'work_tel'); ?>
		<?php echo $form->textField($model,'work_tel'); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'cellno'); ?>
		<?php echo $form->textField($model,'cellno'); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'company'); ?>
		<?php echo $form->textField($model,'company',array('size'=>45,'maxlength'=>45)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'work'); ?>
		<?php echo $form->textField($model,'work',array('size'=>45,'maxlength'=>45)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'heathinsurance_id'); ?>
		<?php echo $form->textField($model,'heathinsurance_id'); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'inventory_id'); ?>
		<?php echo $form->textField($model,'inventory_id'); ?>
	</div>

	<div class="row buttons">
		<?php echo CHtml::submitButton('Search'); ?>
	</div>

<?php $this->endWidget(); ?>

</div><!-- search-form -->